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Factors associated with committed participation in a wellness-walking program for people with lower limb loss: A prospective cohort study.

Prosthetics and orthotics international
April 1, 2019
Christopher Kevin Wong et al. (2 authors)
Comparative StudyJournal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to identify factors associated with committed participation in an amputee wellness-walking program and determine the benefits of committed participation.

Results Summary

Committed participants were more likely to diet, have better balance ability, and have more recent amputations than one-time-only participants. Balance confidence and functional improvements after three sessions were not significant.

Population

Amputees (average age 55.7 years, 68.4% men, 78.4% White, 51.8% with dysvascular amputations, 40.5% with prosthetic knees, 49.1% independent community walkers).

Effective Dosage

Not specified

Duration

3 sessions within 3 years for committed participants

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
amputee wellness-walking program
increase
committed participation
people with recent amputations
-
were more likely to
#1
amputee wellness-walking program
increase
committed participation
people with an interest in dieting
-
were more likely to
#2
amputee wellness-walking program
increase
committed participation
people with better balance ability
-
were more likely to
#3
amputee wellness-walking program
no change
balance confidence improvements
committed participants
-
were not significant
#4
amputee wellness-walking program
no change
functional improvements
committed participants
-
were not significant
#5
Abstract

BACKGROUND:: Wellness activities can benefit health, yet committed adherence is challenging. OBJECTIVES:: Identify factors associated with committed participation in an amputee wellness-walking program and determine benefits of committed participation. STUDY DESIGN:: Prospective longitudinal cohort. METHODS:: Two former Paralympians led the wellness-walking sessions. Participants provided medical history and self-reported balance confidence and prosthetic functional measures. Physiotherapy professionals/paraprofessionals assessed balance and gait. Committed participants-those attending three sessions within 3 years-were compared to one-time-only participants using Fisher's exact and independent t-tests. First and third sessions for committed participants were compared with t-tests. A bootstrapped multivariable logistic regression model was developed using significant univariate predictors. RESULTS:: A total of 305 volunteers averaged 55.7 ± 15.2 years, including 68.4% men, 78.4% White race; 51.8% with dysvascular amputations, 40.5% with ⩾1 prosthetic knee; and 49.1% independent community walkers. Committed participants were initially similar to one-time-only participants ( p > 0.05) except for fewer years since amputation ( p = 0.007), better balance ability ( p = 0.001), and greater likelihood of dieting ( p = 0.030). The final model-balance ability (odds ratio = 2.4), dieting (odds ratio = 3.3), and years since amputation (odds ratio = 0.94)-identified 88.0% of committed participants ( p = 0.007). Balance confidence and functional improvements after three sessions were not significant ( p > 0.07). CONCLUSION:: Committed participants were more likely to diet, have better balance ability, and have more recent amputations than one-time-only participants. CLINICAL RELEVANCE: Knowing which characteristics identify people most likely to become committed participants-such as people with recent amputations, an interest in dieting, and better balance ability-may help health practitioners from different professions promote consistent participation in wellness activities that may benefit self-reported function.

Medical Subject Headings (MeSH)
AdultAgedAmputation, SurgicalAmputeesAnalysis of VarianceArtificial LimbsCohort StudiesFemaleHealth PromotionHumansLogistic ModelsLongitudinal StudiesLower ExtremityMaleMiddle AgedPatient ParticipationProgram EvaluationProspective StudiesProsthesis FittingQuality of LifeRisk AssessmentWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations3
Citations/Year0.5
Relative Citation Ratio0.43
NIH Percentile23.2%
Research Impact Scores
APT Score0.25
Weight Score1.91
Normalized Score0.61
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